Cirrhosis-induced defects in innate pulmonary defenses against Streptococcus pneumoniae

Propst-Graham, Katie L; Preheim, Laurel C.; Top, Elizabeth A. Vander; Snitily, Mary U.; Gentry-Nielsen, Martha J.

doi:10.1186/1471-2180-7-94

Cited by 39 publications

(40 citation statements)

References 55 publications

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“…It is well recognized that cirrhosis is associated with a marked increased risk of invasive bacterial infections such as spontaneous bacterial peritonitis, gram-negative bacteremia and gram-positive sepsis, likely mediated by reduced production of complement and altered neutrophil functions [26,27]. It is also clinically well recognized that cirrhotic patients have suboptimal responses to vaccines such as the hepatitis B vaccine.…”

Section: Discussionmentioning

confidence: 99%

Peripheral CD27−CD21− B-cells represent an exhausted lymphocyte population in hepatitis C cirrhosis

Doi

Tanoue

Kaplan

2014

Clinical Immunology

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Hepatitis C cirrhosis is associated with a profound disappearance of memory B-cells. We sought to determine if this loss is associated with the expansion of the CD27 − CD21 − tissue-like memory B-cells with features of B-cell exhaustion. To this end, we quantified the frequency of CD27 − CD21 − B-cells in healthy, non-cirrhotic HCV-infected, and cirrhotic patients. We examined the expression of putative inhibitory receptors, the proliferative and immunoglobulin-secreting capacity of CD27/CD21-defined B-cell subsets upon B-cell receptor and/or CD40 stimulation. We found that CD27 − CD21 − B-cells are significantly increased in frequency relative to healthy donors in HCV-infected patients. CD27 − CD21 − B-cells were hypoproliferative relative to naïve and resting memory B-cells upon agonistic stimulation, but retained similar capacity for antibody secretion. Conclusion: CD27 − CD21 − tissue-like memory B-cells with exhausted proliferation circulate at increased frequency in cirrhotic and non-cirrhotic HCV-infected patients. This B-cell subset does not appear anergic, exhibiting immunoglobulin-secreting capacity on CD40 agonism indistinguishable from other CD27/CD21-defined B-cell subsets.

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Section: Discussionmentioning

confidence: 99%

Peripheral CD27−CD21− B-cells represent an exhausted lymphocyte population in hepatitis C cirrhosis

Doi

Tanoue

Kaplan

2014

Clinical Immunology

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“…Neutrophils casting out their chromatin in the lung tissue disturb microcirculation and elicit pulmonary dysfunction. In this regard, it is well known that upon thoracic trauma or infection, neutrophils rapidly invade the pulmonary tissue which is followed by ARDS or chonic obstructive pulmonary disease [41][42][43][44] probably supported by proteases localized to NETs. High amounts of chromatin have been detected in Wbrotic lungs and in lungs after infection with pneumococci and redundant neutrophil inWltration [3].…”

Section: Nets and The Putative Pathophysiological Role In Immune Disomentioning

confidence: 99%

The clinical value of neutrophil extracellular traps

Lögters

Margraf

Altrichter

et al. 2009

Med Microbiol Immunol

100

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Neutrophil extracellular traps (NETs) have recently been discovered as a central part of antimicrobial innate immunity. In the meanwhile, evidence accumulated that NETs are also generated upon non-infectious stimuli in various clinical settings. In acute or chronic inflammatory disorders aberrantly enhanced NET formation and/or decreased NET degradation seems to correlate with disease outcome. This review summarizes current knowledge about the relation of NETs in a broad spectrum of clinical settings. Specifically, we focus on the importance of NETs as a predictive marker in severely ill patients and further, we speculate about the potential pathophysiology of NETs.

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“…In a cirrhotic rat model of pneumococcal pneumonia, early and late defects in killing S pneumoniae were identified (19). It is well known that alcoholism is a risk factor for acquisition of pneumonia and for severity of pneumonia (20)(21)(22).…”

Section: Discussionmentioning

confidence: 99%

Pneumococcal Peritonitis: Still with Us and Likely to Increase in Importance

Waisman

Tyrrell

Kellner

et al. 2010

Canadian Journal of Infectious Diseases and Medical Microbiolog

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BACKGROUND: Pneumococcal peritonitis is uncommon and poorly understood.METHODS: As part of a five-year study (2000 to 2004) of invasive pneumococcal disease (IPD) in Alberta, all cases of peritonitis due toStreptococcus pneumoniaewere reviewed and compared with all other cases of IPD.RESULTS: Twenty-three of 1768 (1.3%) IPD patients were found to have peritonitis. Patients with peritonitis were more likely to have cirrhosis, hepatitis C, alcoholism and HIV/AIDS, than the remainder of the patients with IPD. The all-cause mortality did not differ between the two groups. Peritonitis was classified as primary in nine (39%) patients, secondary in 12 (52%) patients, and genitourinary in females, specifically, in two (9%) patients. Pneumococcal serotypes causing peritonitis were under-represented in current vaccines – 17% among peritonitis patients versus 53% for the remainder of IPD patients for the 7-valent pneumococcal conjugate vaccine, and 56% versus 86% for the 23-valent pneumococcal polysaccharide vaccine.CONCLUSIONS: Peritonitis represents a small subset of patients with IPD, but one that is likely to grow in importance given the increase in the number of patients with hepatitis C and HIV, and the reduced coverage of peritonitis serotypes in currently available vaccines.

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Cirrhosis-induced defects in innate pulmonary defenses against Streptococcus pneumoniae

Cited by 39 publications

References 55 publications

Peripheral CD27−CD21− B-cells represent an exhausted lymphocyte population in hepatitis C cirrhosis

Peripheral CD27−CD21− B-cells represent an exhausted lymphocyte population in hepatitis C cirrhosis

The clinical value of neutrophil extracellular traps

Pneumococcal Peritonitis: Still with Us and Likely to Increase in Importance

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